Use of Lotteries for the Promotion of Voluntary Medical Male Circumcision Service: A Discrete-Choice Experiment among Adult Men in Tanzania

Jason J. Ong, Nyasule Neke, Mwita Wambura, Evodius Kuringe, Jonathan M. Grund, Marya Plotkin, Marc d’Elbée, Sergio Torres-Rueda, Hally R. Mahler, Helen A. Weiss and Fern Terris-Prestholt
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Jason J. Ong: Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
Nyasule Neke: National Institute of Medical Research, Mwanza, Tanzania
Mwita Wambura: National Institute of Medical Research, Mwanza, Tanzania
Evodius Kuringe: National Institute of Medical Research, Mwanza, Tanzania
Jonathan M. Grund: Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
Marya Plotkin: Jhpiego, Baltimore, MD, USA
Marc d’Elbée: Department of Global Health and Development, Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, UK
Sergio Torres-Rueda: Department of Global Health and Development, Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, UK
Hally R. Mahler: Jhpiego/Tanzania, Dar es Salaam, Tanzania
Helen A. Weiss: MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
Fern Terris-Prestholt: Department of Global Health and Development, Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, UK

Medical Decision Making, 2019, vol. 39, issue 4, 474-485

Abstract: Voluntary medical male circumcision (VMMC) is effective in reducing the risk of human immunodeficiency virus (HIV). However, countries like Tanzania have high HIV prevalence but low uptake of VMMC. We conducted a discrete-choice experiment to evaluate the preferences for VMMC service attributes in a random sample of 325 men aged 18 years or older from the general population in 2 Tanzanian districts, Njombe and Tabora. We examined the preference for financial incentives in the form of a lottery ticket or receiving a guaranteed transport voucher for attendance at a VMMC service. We created a random-parameters logit model to account for individual preference heterogeneity and a latent class analysis model for identifying groups of men with similar preferences to test the hypothesis that men who reported sexually risky behaviors (i.e., multiple partners and any condomless sex in the past 12 months) may have a preference for participation in a lottery-based incentive. Most men preferred a transport voucher (84%) over a lottery ticket. We also found that offering a lottery-based financial incentive may not differentially attract those with greater sexual risk. Our study highlights the importance of gathering local data to understand preference heterogeneity, particularly regarding assumptions around risk behaviors.

Keywords: lotteries; Tanzania; voluntary medical male circumcision; discrete-choice experiment (search for similar items in EconPapers)
Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:39:y:2019:i:4:p:474-485

DOI: 10.1177/0272989X19852095

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